Supraventricular Tachycardia

Abstract

March 2008

Section 1 Cardiovascular Medicine

V Supraventricular Tachycardia

Melvin M. Scheinman, M.D.
Professor of Medicine, University of California, San Francisco, School of Medicine

Sirisha Sundara, M.D.
Visiting Scholar, University of California, San Francisco, School of Medicine

Over the past decade, enormous strides have been made in the treatment of patients with supraventricular tachycardia (SVT). Although acute therapy for SVT continues to require drugs or cardioversion, advances in the understanding of the mechanisms of SVT have led to the development of catheter ablation procedures for most forms of SVT. These procedures often cure the condition, freeing the patient from the need for lifelong drug therapy. This chapter focuses on the most common forms of SVT, excluding atrial fibrillation. It includes discussion of the diagnosis and management of forms of paroxysmal SVT (PSVT) including atrioventricular nodal reentry tachycardia; atrioventricular reentry tachycardia, including Wolff-Parkinson-White (WPW) syndrome; and atrial tachycardia. Atrial flutter and sinus tachycardia are also discussed. Figures describe the differential diagnosis of tachycardia with narrow and with wide QRS complexes, the relationship between response to intravenous adenosine and the cause of tachycardia, the mechanism of tachycardia induction in patients with dual AV node conduction pathways, and the management of atrial flutter. Electrocardiograms illustrate features of various forms of SVT. A table provides the dosages and potential adverse effects of drugs used to maintain sinus rhythm in patients with SVT. This chapter contains 74 references.

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